Distal Radius Reconstruction With Non-vascularized Proximal Fibular Autograft After en-Bloc Resection of Giant Cell Tumors: A Retrospective Study.

Background Giant cell tumors (GCTs) of the distal radius present significant reconstructive challenges following wide resection. Proximal fibular autograft reconstruction has been a biologically compatible solution, particularly valuable in resource-limited settings. This study evaluates clinical and functional outcomes of this technique. Materials and methods We retrospectively analyzed 14 patients (10 females, four males; mean age 30.9±5.4 years) with eight Campanacci grade II (57.1%) and six patients of grade III (42.9%) distal radius GCTs treated with en-bloc resection and proximal fibular autograft reconstruction. Outcomes were assessed using Musculoskeletal Tumor Society (MSTS) scores, range of motion (ROM) measurements, grip strength, and complication rates. Results Mean MSTS score was 20.6±2.9 (range 15-24). Mean wrist ROM included flexion 28.2°±7.0°, extension 20.7°±6.1°, radial deviation 10.1°±3.3°, and ulnar deviation 10.0°±4.4°. Forearm rotation was well preserved (supination 45.4°±14.7°, pronation 49.6°±10.5°). Grip strength averaged 60.9%±7.4% of the contralateral side. Complications included seven fibula-carpal subluxations (50%), four fibula-ulnar diastases (28.6%), one non-union (7.1%), and one transient foot drop (7.1%). The majority of our patients (n=11, 78.5%) were either pain-free or had mild pain, while only three patients (21.5%) had moderate pain, with none having intolerable pain. All patients achieved independence in activities of daily living. Among seven manual laborers, four returned to their original work while three required modifications; all non-manual workers resumed pre-operative activities. Conclusion En-bloc resection and proximal fibular autograft reconstruction for distal radius GCTs provide satisfactory functional outcomes with acceptable complication rates. While wrist mobility shows some limitation compared to normal values, most patients achieve good functional recovery and return to daily activities.